The results generally support the vascular model of AMD, but some details still need clarification. Therefore, the present study showed many histological characteristics of ASVD in AMD, which suggests an association between them however, there were also some histological characteristics of ASVD that were not found in AMD, which indicates that there exist pathogenic differences between them. Macrophages-derived foam cells were detected near the Bruch’s membrane in late AMD. Additionally, late AMD tended to have higher smooth muscle thicknesses of the choroidal vascular walls, lower numbers of T lymphocytes in the choroid, and higher numbers of macrophages near the RPE and in the choroid relative to normal (P < 0.1). There were no stenosis, plaque, hemorrhage, and calcification.

Geographic atrophy, RPE detachment, and abnormal capillary shape and distribution in the choriocapillaris were observed in the fovea of late AMD. Correlations were found between severity of AMD and lipid accumulation in the deep sclera (+), numbers of drusen between the Bruch’s membrane and retinal pigment epithelium (RPE) (+), amount of collagen in the deep sclera (+), and amount of elastin in the deep sclera (-) (P < 0.1).

Additionally, the normal and late dry AMD eyes were immunostained for a-smooth muscle actin, CD45, and CD68 with Nile red and DAPI. They were stained with hematoxylin and eosin, Oil red O, Masson, Elastica van Gieson, Alizarin red, and Prussian blue. 1 normal, 3 early dry AMD, and 1 late dry AMD eyes were obtained from the Lions Eye Bank of Oregon and systematically dissected. This study investigated the pathogenesis of age-related macular degeneration (AMD) using histological methods that are commonly used for atherosclerotic vascular disease (ASVD). Two other reasons that only the macula is at high risk despite having relatively few drusen are the exclusive presence of soft drusen and the abundant BlamD in this region. The data confirm regional differences in druse morphology, composition, and physical properties, most likely based on different formative mechanisms that may contribute to macular susceptibility for ARM progression. Compound drusen, found in the periphery only, exhibited a composition profile that was not intermediate between hard and soft. Macular hard drusen with a rich substructure profile differed from primarily homogeneous peripheral hard drusen. Specific to hard drusen, which appeared everywhere, were central subregions and reduced RPE coverage. Several substructures, previously postulated as signatures of druse biogenesis, were found primarily in hard drusen. On examination, soft drusen appeared in the macula only, had homogeneous content without significant substructures, and had abundant basal laminar deposits (BlamD).

Peripheral drusen were resilient and never crystallized. On harvesting, macular drusen were friable, with liquefied or crystallized contents. Significant differences were found between the macula and periphery in ease of isolation, distribution of druse type, composition qualities, and substructures. A semiquantitative light microscopic evaluation of 1-mum-thick sections included 12 parameters. The present study was conducted to determine regional differences in morphology that contribute to the higher vulnerability of the macula to advanced disease.ĭrusen from the macula (n = 133) and periphery (n = 282) were isolated and concentrated from nine ARM-affected eyes. Macular drusen are hallmarks of age-related maculopathy (ARM), but these focal extracellular lesions also appear with age in the peripheral retina.

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